In an unexpected move, the California Department of Mental Health Care has informed Kaiser Permanente that it will examine whether the company is providing adequate mental health care services to its 9.4 million California members.
“This non-routine survey is based on complaints received from members, providers and other stakeholders regarding the plan’s behavioral health operations,” said Amanda Levy, deputy director of health policy and stakeholder relations for the department.
Levy said regulators would assess Kaiser’s internal and external provider networks, timely access to care, intake and follow-up appointment processes, appointment scheduling processes, levels of care and decision-making processes. associates, medical record documentation and retention practices, and urgent appointment monitoring.
Kaiser Permanente leaders issued a statement through Steve Shivinsky, director of national media relations. In part, he said, “We appreciate the DMHC’s interest and responsibility in understanding how we are working to provide clinically appropriate care to those who rely on us for their mental health services. We welcome the opportunity to review our performance and collaborate on further areas of improvement.”
Kaiser mental health doctors, represented by the National Union of Health Care Workers, have complained that their clients face weeks-long waits for successive appointments and grueling schedules that leave doctors little time to write notes or connect patients with comprehensive services.
“We have been pushing Kaiser Permanente to increase staffing and invest more in behavioral health care so we can address the needs of our patients, but Kaiser continues to refuse,” said union leader psychologist Ken Rogers. in the Sacramento region. “Hopefully this investigation will finally force Kaiser to stop denying that it is failing its behavioral health patients and start working with us to improve its services.”
In a press release issued Thursday, union leaders pointed to previous fines and settlement agreements the health care giant had signed with the Department of Managed Health Care, including one from 2013 when the company agreed to pay $4 million. and take corrective action after The agency found that it had failed to provide timely access to mental health care.
State records also show that regulators found problems with timely access to behavioral health services and availability of care during a routine survey in 2016, but by 2019, Kaiser had instituted a corrective action plan that, according to regulators, was working to alleviate the problems.
Cited regulators Kaiser for seven other deficiencies in the 2019 survey, it focused primarily on how the company handled consumer complaints and monitored whether they were resolved effectively.
Regulators were conducting a follow-up inspection to determine whether Kaiser had corrected these deficiencies when it announced the non-routine survey to determine whether the company was in compliance with laws requiring timely access to behavioral health care.
Sharp rise in Kaiser complaints
The “California Department of Mental Health help desk received a 20% increase in Kaiser behavioral health complaints in 2021 compared to 2020,” wrote Rachel Arrezola, a spokeswoman for the department, in response to a query from Bee. The department is “committed to ensuring that members have adequate access to behavioral health care when they need it.”
Kaiser’s Shivinsky said, “We believe a careful and impartial review can help us and other health plans in California address the challenges we all face. We know we cannot solve the challenges of the national mental health crisis on our own and look forward to the collaboration of the entire mental health community.”
Both the company and the union noted that California and the nation as a whole have seen an increase in demand for behavioral health services amid the COVID-19 epidemic.
The nonprofit organization Mental Health America estimated that more than 2.5 million young people in the US have severe depression, with black, indigenous, and other youth of color at greatest risk.
In another key measure of mental health, the Centers for Disease Control and Prevention reported earlier this month that fatal overdoses have skyrocketed by 15% in 2021 with more than 107,000 Americans dying. This follows a 30% increase in such deaths in 2020.
New California law requires timely appointments
Union officials said it’s about time Kaiser got down to business managing behavioral health services. They warned state officials that the company was woefully unprepared to comply with a new state law that takes effect July 1 and requires health plans to accommodate mental health therapy appointments within 10 business days, unless the treating physician determines that a longer wait would not be harmful.
Union officials said a 2020 survey of Kaiser doctors found that on a daily basis, 65% of respondents are scheduling their patients for later return appointments than is clinically appropriate.
Shivinsky said Kaiser has been on a multi-year journey to improve the way mental health care is delivered, but like other providers, it has faced challenges amid a national shortage of physicians in the field. The company has expanded its ability to provide virtual care to patients who want it; embedded mental health professionals in primary care clinics, pediatric settings, and emergency departments; and expanded collaborative care programs for patients diagnosed with anxiety and depression.
“Despite all these efforts, we continue to face the same challenges as others,” Shivinsky said. “We haven’t solved the problems facing mental health care, and the pandemic has set all of us back.”
Arrezola said consumers should file a complaint with their plan if they don’t get timely access to behavioral care. If they’re not satisfied with their health plan’s response or have been in their plan’s grievance system for more than 30 days for non-urgent issues, he said, they should contact the DMHC Help Center for help at (888) 466-2219 or www.HealthHelp.ca.gov.
This story was originally published May 21, 2022 5:25 a.m.
.
